After Congress fails to repeal ACA, all eyes on Tom Price

HHS Secretary Tom Price has the unenviable job of administering a healthcare law that he does not support. But it's unclear whether that means he will let the ACA's individual marketplaces deteriorate. (Mark Taylor / CC BY 2.0)

Now that Republicans have tabled legislative efforts to repeal and replace the Affordable Care Act—at least temporarily—the focus has shifted to one man: Tom Price.

Price, the new Department of Health and Human Services Secretary, was meant to be in charge of implementing a new healthcare policy overhaul crafted by Congress. Instead, he is faced with the task of administering the various aspects of a law he opposes.

"Tom Price is the kind of guy that you hire if you want to uproot the Affordable Care Act,” Nicholas Bagley, a University of Michigan law professor who specializes in regulatory law, told Talking Points Memo. “He’s not the guy you want if you want to make it work."

In an interview with FierceHealthcare before the GOP decided to pull the American Healthcare Act, Polsinelli Senior Policy Adviser Julius Hobson predicted that if the bill doesn’t pass, the Trump administration would “try to strangle [the ACA] to death administratively."

For example, Price has the authority to loosen the definition of which services are included in essential health benefits—though he can’t eliminate that part of the ACA entirely, The Hill noted.

And because the Trump administration can now decide the fate of House Republicans’ lawsuit challenging the legality of the cost-sharing reduction program, Price could choose to stop those payments to insurers—a move that would greatly destabilize the ACA marketplaces.

Already, the Trump administration has moved to halt open enrollment advertising—a decision that the HHS Office of Inspector General is investigating—and issued an executive order that directs agencies to lessen the “burden” imposed by the ACA.

Yet Tom Scully, who led the Centers for Medicare & Medicaid Services under former President George W. Bush, told The Hill that he doesn’t think Price is likely to intentionally tank the healthcare law so much as put a “conservative spin on it.”

In fact, the Price-controlled HHS has issued a proposed rule aimed at stabilizing the individual marketplaces that draws upon some suggestions from insurance companies, such as shortening open enrollment periods.